Indiana sleeping

“I cannot sleep unless I am surrounded by books.” Jorge Luis Borges (read from a client’s t-shirt)

Sleep is a daily topic in my psychotherapy office and a problem for many people.  Without enough good quality sleep we don’t function well.  Sleep is essential to our well-being, but all too often we try to get by without enough of it.  Inadequate sleep produces problems with mood, cognition, and health.  We all know that sleepy people are groggy, forgetful, irritable, listless and accident-prone, but it is even more serious than that.  Research shows that lack of sleep can cause anxiety, depression, mood swings, memory problems and obesity.  Inadequate sleep is linked to serious diseases including breast cancer, colon cancer, diabetes, strokes and heart disease. Several studies have linked a deficit in sleep to a significantly shortened life span.

Sleep problems take many forms: poor sleep habits, difficulty falling asleep or staying asleep, and poor sleep quality.

The easiest  problem to solve is poor sleep habits.  Good sleep habits include the following:

1. Schedule enough time for sleep each night –7-8 hours depending on your personal need–and go to bed at approximately the same time most nights.

2. Limit alcohol and caffeine intake.

3. Avoid napping.

4. Sunlight and exercise during the day can improve sleep at night.

5. Establish a bed time routine that allows for winding down and signals sleep for you.

6. Stop using electronics such as television or computer an hour before bedtime.

7. Sleep in a dark, quiet, cool room.  Use earplugs, white noise machines, fans, block out shades or whatever you need to create the best sleeping environment for you.

If you have good sleep habits and have trouble falling asleep or staying asleep long enough, you may need help from a doctor to determine why you can’t sleep and what the best course of treatment is for you.  You might have a medical condition, a mood disorder, or  a sleep disorder that can be diagnosed and treated.

Solving a sleep problem can make you feel like a new person.  One of my clients found that by adjusting her schedule to get just 45 more minutes of sleep each night she has energy to do something fun when she gets home from work and get through her after-work chores each day without a struggle.  Another client was diagnosed with sleep apnea and now sleeps with a C-Pap machine.  He had been falling asleep at work and having memory problems and now feels alert and on top of things throughout the day.

I often have clients who are suffering from feeling tired all the time, but don’t think they can do anything about it, or they believe that  finding a solution is hopeless or too hard.  I want to encourage you to think of sleep as something you need in order to sustain an acceptable  quality of life, something worth prioritizing up there with food and shelter!  It’s a problem well worth solving even it takes awhile to figure out.

Sculpture by Jan Poinsett

Today in my psychotherapy group, “Living Well with Bipolar Disorder and Depression,”  we  discussed isolation vs. connectedness.  Group members shared that while  isolation is often their choice when depressed,  ultimately connecting with others is more helpful to them. Group members find that connection gives them comfort, energy and hope in the midst of their depression.

Now there is more than shared experience to support the benefits of connection.  Research using brain scanning technology confirms that our brains actually change under the influence of others.   Interpersonal neurobiologists, including Daniel Siegel and Allan Schore, use the term “regulation” to describe how we internally manage our emotional and physiological responses to stress and stimulation, and they have demonstrated in their research that we rely on others to help us in this process.  Connection with others helps us calm and quiet ourselves in difficult moments, and over the course of time, even heal from early psychological wounds.  The most exciting new thought is that our brains are not as unchangeable as once believed, but can be changed and healed through positive relationships.

A March 24, 2012, article, The Brain on Love – NYTimes.com  by Diane Ackerman gives a nice summary of the theory while focusing on love relationships.  An excerpt:

“All relationships change the brain–but most important are the intimate bonds that foster or fail us, altering the delicate circuits that

shape memories, emotions and that ultimate souvenir, the self.”

Interpersonal neurobiology also supports the usefulness of  the client-therapist relationship and the relationships formed in group therapy.  If you are interested in reading more about interpersoan neurobiology and psychotherapy,  Austin In Connection :: Psychotherapy for articles and links.

The quality of the relationship between therapist and client is the most significant factor in the success of the therapy experience so it’s important to make a thoughtful choice. There are many excellent psychotherapists in Austin to choose from. Here are some tips for choosing a therapist:

Clarify for yourself what your goals are for therapy and what kind of therapist you are looking for. This means define the issue or issues that you know you want to address and how you want to approach the work. This will help when you are calling potential therapists and when asking for referrals.

Ask friends, family members and professionals such as your family doctor for referrals.

Keep the practical issues in mind–fees, location, accessibility, and hours.

Use the internet. Psychology Today has a large directory of therapists that is searchable by zip code and specialty. Many therapists also have personal websites that give a great deal of information about their approach, their practice and their personality.

Prepare a short list of questions to ask potential therapists. This list should include what is most important to you. You might ask about their experience in working with certain issues, how they approach their work theoretically, about fee and billing practices, and availability.

If you have been in therapy before, keep in mind what worked for you and what didn’t and ask questions based on that knowledge.

Talk to several therapists before making an appointment. See more than one therapist before you decide if possible.

Don’t decide on a therapist until after you have met with them in person. If you have concerns about the relationship as it progresses always share your concerns with your therapist.

Listen to your gut–did you feel comfortable with the therapist? Did you feel understood? Were your questions answered clearly? Did the session start and end on time? Was the office a good environment for you to work in? Did the therapist go over essentials about their practice policies, fees, confidentiality?

If you begin work with a therapist and have doubts or concerns about your work together, discuss this with the therapist. A good therapist welcomes your feedback and can be more effective if you are open about your feelings and thoughts. You can decide together where to go from there.

Obstacles to change can seem like giant boulders in your path.  You may know what you want to change but just can’t seem to move forward. In my “Living Well” psychotherapy group here in Austin, members came up with this list of common issues that block the way to progress:

Fear: We want the change but are afraid of the challenges that may follow.
Old wounds: We aren’t done grieving old wounds so can’t leave them behind.
Past failures: We identify with a past disappointment so much that we believe we are doomed to fail again.
Isolation: We lack the support and encouragement we need to move forward.
Self-doubt: We don’t believe we can succeed because we don’t believe in ourselves.
Self-attack:  We sabotage ourselves with self-defeating thoughts and behaviors.

If you want to know more about your obstacles to change, you might try this exercise: Draw a path representing what you want to change, then draw across it a rock wall representing the obstacles you face in moving forward. On each rock in the wall write a word that comes to mind as you contemplate your struggle with change. Explore these obstacles one at a time by journaling, talking with a friend, or working with a therapist. Identify what you need to do to dismantle, scale or get around this rock wall, and make a plan of small forward steps. Don’t forget that isolation is an obstacle to change, and be sure to ask for support from friends, family, 12-step or support groups, or professionals.